A comparative study of the effect of health insurance on women's use of health facility delivery: Evidence from demographic health survey in Benin Republic

Studies in the Benin Republic have identified contextual factors that determine health facility delivery among women of reproductive age. However, it is not certain if the same set of factors predicts facility delivery for women who enrolled in health insurance and those who did not. The study seeks to compare the determinants of health facility delivery for mothers under health insurance and those that are not in the Benin Republic. The study used data for 33,078 women of reproductive age, drawn from the most recent Benin demographic and health survey (2017-18). The characteristics of the women were described using simple proportions and frequency. Binary Logistic regression was used to examine determinants of health facility delivery for both groups of women. The result showed that only 0.7% of the women were under health insurance coverage. The prevalence of health facility delivery was high in the enrolled group but not in the unenrolled group (98.3% vs. 87.8%). The uniform determinants of health facility delivery across the two groups were household wealth, education, employment, land/house ownership, media exposure, a minimum of four antenatal contacts, and place of residence. To improve the coverage of health facility delivery, a multi-pronged approach should be used to improve household socioeconomic status, encourage media use among women, expand education opportunities for women, and specifically target rural women in Benin. (Afr J Reprod Health 2022; 26[6]:104-115).

Diabetes in the public healthcare sector of four South African provinces: A comparative analysis

The growing burden of diabetes has long been under the radar in developing countries such as South Africa (SA). In recent years, there has been an unprecedented and exponential increase in recorded and undiagnosed diabetes mellitus (DM) cases. Unreliable data collection, overburdened health systems and poor infrastructure have all proved to be barriers to achieving optimum disease management. The District Health Information System (DHIS) serves as the data collection tool for the SA public healthcare sector. It is used in all nine SA provinces to gather data without individual patient identifiers. Objective. To analyse and compare the DM data collected by the DHIS in the Western Cape (WC), Eastern Cape (EC), KwaZulu-Natal (KZN) and Gauteng provinces of SA. Methods. An audit of diabetes-related data from the DHIS for 2016 was conducted. The data were then analysed using Excel. Time-series and cross-sectional analyses were made possible using pivot tables. Graphics were designed using Thinkcell software. Results. Of the four provinces surveyed, Gauteng recorded the highest incidence of DM, 67% higher than the reported global DM incidence estimate, while the WC had the lowest incidence. A similar pattern was also noted regarding the incidence of DM in people aged <18 years, with Gauteng having the highest and WC the lowest prevalence results. When comparing the number of DM-related consultations conducted in each province, the metropolitan districts were highlighted as hotspots of activity for DM care. This study found a moderate inversely proportional relationship between the incidence of DM in all provinces and education deprivation (p<0.05). Among the provinces that collected data on screening (excluding EC), KZN recorded the highest number of diabetic screenings. Conclusion. Metropolitan areas were highlighted as areas to be targeted, further reinforcing the current connection observed between urbanisation and DM in SA. The presence and recording of screening efforts is an excellent step in the right direction for the SA public healthcare sector and the DHIS. With improved interprovincial co-ordination regarding standardisation of the criteria and specifications of data collection fields, and enhanced training for data officers and primary collection agents, good quality and rich data is a very close possibility.

Discrepancies between clinical diagnoses and autopsy findings: A comparative study conducted in South Africa

The anatomical pathology autopsy serves several purposes, notably as a quality management tool for evaluation of accuracy in clinical diagnosis. Despite its value, for various reasons there has been an international decline in autopsies conducted. In the modern medical era, with all its advances in technology, diagnostic techniques and interventions, there is still a high discrepancy between clinical diagnoses and postmortem findings.Objectives. To establish the discrepancies between clinical diagnoses and postmortem findings in anatomical pathology autopsies.Methods. A retrospective, descriptive study was conducted over the 4-year-period 2014 - 2017. The clinical diagnoses and postmortem findings of cases referred to the Department of Anatomical Pathology at the University of Pretoria, South Africa, were evaluated and compared using the modified Goldman criteria.Results. A total of 288 cases qualified for the study and were evaluated. The gender distribution was 155 (53.8%) male and 133 (48.2%) female, with the majority of cases in the age group 19 - 60 years (mean 36.4). The majority of the cases were referred by internal medicine, followed by paediatrics. The most common cause of death in major missed diagnoses was pulmonary conditions. Of the cases, 115 (39.3%) had a major discrepancy and 62 (21.5%) a minor discrepancy.Conclusion. This study showed that there is still a high discrepancy between clinical diagnoses and postmortem findings, similar to studies conducted globally. The current COVID-19 pandemic may be a driver for revival of the anatomical pathology autopsy, and future studies are recommended to evaluate whether the decline can be reversed

Comparison of the duration and quality of epidural analgesia between plain bupivacaine alone and plain bupivacaine with tramadol in lower limb orthopaedic surgeries

Background: This study was aimed at comparing the duration and quality of epidural analgesia between plain bupivacaine alone with plain bupivacaine and tramadol in lower limb orthopaedic surgeries. Method: This was a prospective randomized double blinded control study involving 74 ASA I and II patients scheduled for elective lower limb orthopaedic surgeries. Group A (n=37) received 19mls of 0.5% epidural plain bupivacaine with 1 ml of water for injection, while group B received 19mls of 0.5% epidural plain bupivacaine with 1ml (50mg) of preservative freetramadol. The duration of analgesia was from the time of epidural block to the time of rescue analgesia. While, the quality of block was measured with Visual Analogue Scale (VAS) and Bromage scale. Results: Thestudy ages were between 16-60years,consisting of 22(60%) male and 15(40%) female in group A, while in group B 20 (54%) were male and 17(46%) female. It showed the mean duration of analgesia were 189.05±21.92min and 254.19±32.78min in group A and B respectively with p <0.01.The intra-operative VAS scores between the two groups did not show any significant difference between study groups (P> 0.05).The differences of grades of motor block and maximum sensory block height were not statistically significant (P=0.26) among the study groups. Conclusion: The addition of 50mg (1ml) of tramadol to plain bupivacaine epidurally prolonged the duration of analgesia and improved the quality of analgesia when compared to the use of bupivacaine alone

Etude comparative des profils de dissolution in vitro de quinine sulfate générique et princeps en utilisant la Chromatographie Liquide Haute Performance

Introduction : La quinine est une molécule préconisée pour le traitement du paludisme dans les régions où les souches de P. falciparum sont poly-résistantes. Face à l'importante utilisation de ses médicaments génériques d'une part, et au fléau des médicaments de qualité inférieure d'autre part, il devient plus que nécessaire d'appuyer les données des tests physico-chimiques par celles de dissolution in vitro dont l'évaluation et la comparaison des cinétiques permettra de prédire le comportement in vivo du principe actif et par conséquent l'efficacité du médicament générique. L'objectif de la présente étude était de réaliser une étude comparative de la cinétique de dissolution d'un princeps et d'un générique à base de quinine comprimé 300 mg commercialisés à Kinshasa.Matériels et méthodes : L'étude a été réalisée en utilisant trois milieux de pH différents (1,2 - 4,5 - 6,8) tels que recommandés par l'Agence Européenne de Médicament et en se servant d'un appareil de dissolution, tandis que l'équipement de chromatographie liquide à haute performance couplée à un détecteur à barrette de diodes a été utilisé pour la quantification. La méthode statistique fit factor a été appliquée pour comparer les résultats de dosage de la quinine dans les trois milieux tout en ayant évalué le biais à différents temps de dissolution.Résultats : Les différents échantillons de médicaments générique et princeps ont été conformes quant à l'identification et au dosage de la quinine, par contre leurs cinétiques de dissolution étaient non-similaires.Discussion : Ceci pourrait avoir une influence sur l'efficacité du produit générique et la sécurité des consommateurs, dénotant l'importance d'examiner les profils de dissolution des génériques avant toute autorisation de mise sur le marché plus particulièrement dans les pays en voie de développement

Médulloblastome versus épendymome : qu'apporte l'IRM multimodale

Objectifs : décrire et comparer les aspects IRM de l'épendymome et du médulloblastome de la fosse postérieure. Matériels et méthodes : étude rétrospective incluant 29 cas de médulloblastome et 11 cas d'épendymome de la fosse postérieure. Les examens étaient réalisés en pondération T1 sans puis après injection de gadolinium, T2, T2*, Flair, diffusion, séquences de perfusion et de spectroscopie. Résultats : sur le plan morphologique, nous n'avions pas relevé de différence significative en ce qui concerne la taille tumorale, leur signal et leur rehaussement. Par contre les épendymomes étaient de topographie intra ventriculaire dans 90,9% contre 62,1% pour les médulloblastomes avec une extension dans le trou occipital respective de 81,8% et 10,3%. Les médulloblastomes présentaient une restriction de la diffusion dans 86,2% contre 27,3%. Une néoangiogenèse était notée dans 79,3% des médulloblastomes contre 45,5% pour les épendymomes. Sur le plan spectral, une chute du NAA et de la créatine associée à une augmentation du pic de Choline était retrouvée chez tous nos patients avec accumulation de myo-inositol dans 72,8% des épendymomes et présence de taurine dans 34,5% des médulloblastomes. Conclusion : l'IRM morphologique associée aux techniques avancées permet une meilleure approche diagnostique du type et du grading des tumeurs de la fosse postérieure

Comparative Sonographic Evaluation of the Anteroposterior Dimensions of the Pancreas in Diabetics and Nondiabetics

Background: The pancreas is an insulin­producing gland and is prone to varying degrees of destruction and change in patients with diabetes mellitus (DM). Various morphological changes including reduction in the pancreas dimensions have been described in DM.Objectives: To determine pancreatic anteroposterior (AP) dimensions in diabetics by sonography and compare with nondiabetics. To also evaluate the correlation of the AP dimensions with patient's anthropometry, as well as the duration of the disease in comparison with nondiabetics.Materials and Methods: This is a comparative cross­sectional study involving 150 diabetics with 150 sex and age matched healthy normoglycemic group used as controls. Sonographic measurements of the AP dimensions ofthe pancreatic head, body, and tail of both study groups were performed with the use of 3.5 MHz curvilinear array transducer of a SonoAce X4 ultrasound machine. Data were analyzed using Statistical Package for Social Sciences version 17 (SPSS Inc., Chicago, IL, USA). A statistical test was considered significant at P ≤ 0.05 and 95% confidence interval.Results: Pancreas AP dimensions were significantly smaller in diabetics compared to those of the controls. The mean dimensions were 1.91 ± 0.26 cm, 0.95 ± 0.12 cm, and 0.91 ± 0.11 cm for the head, body,andtail,respectively, in diabetics and 2.32 ± 0.22 cm, 1.43 ± 0.19 cm, and 1.34 ± 0.20 cm in the control (P < 0.001 in all cases). The dimensions were also significantly smaller in the Type 1 diabetics compared to Type 2 (P < 0.001 in all cases). The mean duration of illness for the Types 1 and 2 diabetics were 3.09 ± 1.38 and 3.78 ± 3.12 years, respectively. Longer duration of illness was associated with smaller pancreas body and tail dimensions, while pancreas head dimension was not significantly affected by the duration of illness.Conclusion: Diabetics have smaller pancreas AP dimensions compared to the normal population

The feasibility of Determining the Position of an Endotracheal Tube in Neonates by using Bedside Ultrasonography Compared with Chest Radiographs

Background. Neonates in our neonatal intensive care unit (NICU) receive a large amount of radiation with X-rays (XRs) being done daily; even more often with reintubation; repositioning of endotracheal tubes (ETTs) and confirmation thereof; which has been our NICU policy for many years. Objective. To investigate the feasibility of determining the position of ETTs in neonates by using bedside ultrasonography (BUS); and to compare the results with those obtained from chest XR (CXR) findings. Methods. A prospective; cross-sectional study was done on intubated neonates in the NICU at Universitas Academic Hospital; Bloemfontein; to determine the position of ETTs by using BUS.Results. Thirty intubated patients included in this study had a median age of 13.5 days and a median weight of 1.6 kg. Ninety-three per cent of ETT placements were considered optimal when visualised by BUS; while 73.3 were considered to be placed optimally when CXR was viewed. When CXR and BUS findings were compared regarding optimal placing; the agreement was poor (?=0.10; 95 confidence interval -0.2 - 0.4). In four patients; the distance from the aortic arch to the tip of the ETT was outside the expected range of 1.5 - 2.2 cm: in two patients it was 1.5 cm (6.7) and in the other two 2.25 cm (6.7). BUS measurements were done mainly in extended head (53.3) or neutral (36.7) position. Conclusion. Although poor agreement between CXR and BUS findings was obtained; possibly because of handling of patients with secondary shifting of ETTs; BUS was found not to be comparable with CXR; but an alternative feasible method to determine the optimal position of ETTs in the trachea in neonates when using other reference points; with the added advantage of no radiation exposure

A Comparative Study of the Prevalence and Risk Factors of Lower Back Pain among Aircraft Technicians in Ethiopian Airlines

Lower back pain (LBP) is a global concern among workers in various occupational settings. The purpose of this cross-sectional study was to determine the prevalence of LBP and its risk factors among aircraft technicians (ACTs) in Ethiopian Airlines. A self-administered questionnaire was used to obtain data from 294 ACTs. The prevalence of LBP among ACTs was 47.1 during the past six months. Duration of employment was signifi cantly associated with experiencing LBP as ACTs with 7 - 9 years working experience were almost eight times more likely to experience LBP that those with 1- 3 years of experience (OR = 7.86; 95 CI 1.59-52.55 ). Significant associations were observed between the prevalence of LBP and pulling and pushing heavy loads (OR = 3.17; 95 CI 1.49-6.74); lifting heavy objects (OR = 1.90; 95 CI 1.01-3.60); and carrying heavy loads (OR = 2.02; 95 CI 1.15-3.57). Bending (OR = 2.13; 95 CI 1.30-3.49); lifting hard to hold loads (OR = 2.78; 95 CI 1.72-4.49); and working with twisted trunks (OR = 2.15; 95 CI 1.34-3.43) were also signifi cantly associated with LBP. Relevant occupational health and safety interventions should be designed and implemented to reduce the prevalence of LBP in these ACTs; taking into account the nature of the work conducted

Pharmacist Prescribing in the United Kingdom and the Implication for the Nigerian Context

Background: Non-medical professionals including pharmacists have been granted the right to prescribe medicines in the United Kingdom. In Nigeria; only medical doctors; dentists and some nurses in primary care facilities have the legal right to prescribe medicines and patients' access to prescriptions can be seriously affected by a shortage of prescribers and long waiting times in hospitals.Objective: This article presents a review of pharmacist prescribing in the UK including its model; impact; facilitators and barriers and discusses the implications for the Nigeriancontext. Methods: A literature search was conducted in Medline; Embase; International Pharmaceutical Abstracts and Cumulative Index to Nursing and Allied Health Literature databases for studies investigating pharmacist prescribing in the UK between 1990 and August 2013.Results: The review identified that legislative change in the UK has enabled pharmacists to prescribe first as supplementary prescribers then as independent prescribers. This policy change was driven by the desire to increase patients' access to medicines and promote the utilisation of the skills of non-medical professionals while maintaining patient safety. Although more robust research evidence is needed to demonstrate the effectiveness of pharmacist prescribing; available evidence shows that it has had an impact on patient access to medicines.Conclusion: Pharmacist prescribing has the potential to promote access to prescription medicines; free doctors' time to enable them deal with complex cases and promote efficient use of pharmacists' clinical skills in Nigeria as it does in the UK. Factors which can promote the extension of prescribing rights to pharmacists in Nigeria include the current level of pharmacists' training and the clinical roles of pharmacists in some tertiary hospitals

Pattern and Mortality Rate of Traumatic Injuries in a Tertiary Hospital in Nigeria- 2 Year Comparative Analysis

BACKGROUND.Trauma ranks as one of the leading cause of mortality in Sub-Saharan Africa. The aim of this study was to compare the pattern of injuries and mortality rates in our hospital.METHODS.Demographic and clinical data of patients that sustained injuries due to trauma to all regions of the body were included in the study. The cause; type and site of the injuries were documented. Cases of mortality with the sites and severity of injuries and number of days on admission before death was documented for each period.RESULTS.A total of 673 patients presented in the first period (March 2011 to February 2012) and 1869 in the second period (March 2012 to February 2013). More males were involved with injuries in both periods. RTA and Burns were responsible for most of the injuries in both periods. Head injury was highest followed by the extremities in both periods. In the first period; a total of 46 patients died with mortality rate of 6.8%; in the second period; a total of 47 patients died with mortality rate of 2.5%.CONCLUSION.There was an increase in the cases of trauma in the second period of the study. The pattern in both periods was similar but mortality figure was much lower in the second period

A Cross-Sectional Survey on the Lifestyle and Healthseeking Behaviour of Basotho Patients with Diabetes

Objectives: The objectives of the study were to determine the level of practice of a healthy lifestyle; to assess the health education provided to patients with diabetes and to determine the prevalence of obesity among Basotho patients with diabetes. Design: A cross-sectional study enrolled 192 patients between November 2004 and July 2005. Descriptive statistics on demographic; socio-economic and lifestyle data were computed. Weight; waist circumference and hip circumference measurements were taken to compute body mass index (BMI); waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR). Setting and subjects: Patients with diabetes attending three hospitals in Lesotho were recruited in the study. Outcome measures: These included obesity indices; the quality and quantity of physical exercises; the quality and quantity of provided health education and the frequency with which the subjects sought medical help. Results: The participants' mean age was 54.73 years. The prevalence of smoking (14.6) was higher than that of drinking (9.4). Only 20.8 of the participants participated in recommended physical exercise. Most participants (95) consulted their physicians on a regular basis. The Health Education Quantity Index was very low: 49.9. The prevalence of obesity measured by BMI; WHpR and WHtR was 67.7; 69.8 and 95.3 respectively. Conclusion: The practice of a healthy lifestyle was suboptimal; but help-seeking behaviour was satisfactory among participants. It is recommended that health education and the promotion of a healthy lifestyle are encouraged; that diabetes education is rendered by accredited educators or healthcare providers trained in communicating health messages; and that the fight against obesity is made a priority

Depression among People Living with Human Immunodeficiency Virus Infection/Acquired Immunodeficiency Syndrome in Benin City; Nigeria: A comparative Study

Background: Depression is a common co-morbidity among persons living with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) (PLWHAs). It is associated with poor treatment adherence and higher mortality rates. Few reports have; however; emanated from developing countries where socioeconomic factors may confound this association. Materials and Methods: We conducted a cross-sectional comparative study of PLWHAs and apparently healthy staff of three LGA's. The depression module of the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN) and the Beck Depression Inventory (BDI) was used to diagnose depression and depression symptom severity; respectively. Results: Depression was commonly co-morbid among individuals with HIV/AIDS. It was five times more common in PLWHAs than in apparently healthy populations (29.3vs. 7.3; OR: 5.25; 95 CI: 2.50-11.76). A similar trend was observed for depression symptom severity. Among PLWHAs; depression was significantly more likely among females (OR: 7.91; 95 CI: 1.83-71.00; P 0.01); those unemployed (OR: 2.94; 95CI: 0.18-1.82; P 0.04); and with an illness duration 3 years (OR: 7.90; P 0.0001). Having at least one child (OR: 2.79; 95 CI: 1.25-6.16; P 0.001) and living with others (OR: 4.71; 95 CI: 1.51-15.52; P 0.003) significantly reduced depression risk. Conclusion: Depression was commonly co-morbid among PLWHAs studied. Clinicians should be aware of risk factors for depression among PLWHAs in order to improve treatment outcomes

Prevalence of Obesity among Adolescents in Ile-Ife; Osun state; Nigeria Using Body Mass Index and Waist Hip Ratio: A Comparative Study

Obesity is a global epidemic not just among adults but also among children and adolescents. This study described the prevalence and pattern of obesity among in-school adolescents in Ile-Ife; Osun State using two standard methods; Body Mass Index (BMI) and Waist Hip Ratio (WHR) with a view of comparing the two methods as well as identifying any correlation between the two methods. Materials and Methods: Five hundred male and female respondents; aged 10-19 years; were randomly selected through a multistage sampling technique from private and public schools in Ife Central Local Government Area. Quantitative data were collected with the aid of a pre-tested; semi-structured; self-administered questionnaire. Anthropometric measurements of respondents; BMI and WHR; were recorded. Chi square and linear regression analyses were used. Statistical significance was tested at the 5 level. Results: The prevalence of obesity was 4.2 using BMI of which 12 (57.1) were females and nine (42.9) were males. There was significant association between sex and BMI; ?2 = 9.490 ( P = 0.020). Using WHR; the prevalence was 37.2 of which 180 (96.8) were females and six (3.2) were males. There was also significant association between sex and WHR ( P 0.001). Weak correlation ( r

The Role of Stigmas in Mental Health: A Comparative Study

Background: HIV (Human immunodeficiency Virus); AIDS and cancer are feared terminal diseases. HIV sufferers are known to be stigmatized. The stigma surrounding cancer; unfortunately; is hardly the focus of psychological investigations; and hence this provoked the need to compare the stigma suffered by both groups; and how these have impacted on the psychological functioning of the disease sufferer. Objectives: The study had two main objectives; firstly; to explore whether HIV patients suffer more stigma than cancer patients or not; and secondly; to understand the most common type of stigma and if stigma is associated with psychopathology. Psychopathology is measured with GHQ-28 which evaluates somatic complaints; anxiety; depression and social dysfunction. Method: The study was a survey; and descriptive in nature; and anchored on two hypotheses: Firstly; that HIV patients will experience more stigmas than cancer patients and consequently report more psychological dysfunctions. Secondly that there will be a significant difference between types of stigma and the symptoms reported about them. Data were collected from a conveniently sampled group of 50 HIV positive patients and another 50 patients diagnosed with cancer; in two clinics and a hospital around the Gauteng Province. The majority of the participants were females; numbering 62 (62; 0); whilst 38 (38.0) were males. The age of the respondents ranged from 20-73 years with a mean age of 44.4 years (s.d. = 11.6). Results: Results revealed a significant main effect for enacted stigma F = (1.98); = 17.629; p .001 and anxiety F

Comparative Analysis of Global Health Statistics; Implication for Health Education and Promotion

This study examined the differences in health statistics of some selected developing and developed countries. Secondary data were sourced from various international sources such as World Fact book (2008); World Health Organization (2010) and UNICEF(2010). The variables of the study were HIV/ AIDS prevalence and education statistics of Nigeria; Ghana Australia; USA countries formed the dependent. HIV/AIDS is not significant as a predictor of life expectancy in these countries as HIV/ AIDS statistics of the five countries contributed 5.4to life expectancy (R=0.548). However it is a predictor of life expectancy in Ghana and Nigeria; with a t-value of 2.975 and -3.090 respectively. Both were significant at 0.05 alpha levels. The t-value of all five countries shows that none was significant in the use of education as a predictor of life expectancy. It was recommended that Nigerian government should to raise health expenditure to the agreed 15of the budget and make more effort at increasing school enrollment at the primary and secondary levels. This must be followed with employment opportunities to raise the living standard of the people. This comprehensive approach to health status will increase life expectancy among Nigeria

Comparative Study of the Primary Healthcare Systems in China and Mali

"Background: Community health centres (CHCs) are an important component of the health system in Mali and China. Despite patient support and commitment from the authorities; the management and the quality of care of these structures need to be improved. This research aimed to compare the management style of the relevant boards with users' satisfaction pertaining to CHC services in Mali and China. Method: Between September 2009-January 2010; a study was conducted in eight CHCs in Mali and in 16 CHCs in China. A total of 480 householders; [60 (Mali) and 320 (China)]; and 24 management committee members (Mali) and 48 management committee members (China) were interviewed. An in-depth interview technique was used on members of the management committee; while a structured interview was carried out to collect data during face-to-face contact with householders in their residences. In residences in which there were two or more households; the first willing householder was interviewed. Questions about the level of satisfaction were coded from 1-5 and ranged from ""excellent"" to ""very bad"" respectively. Results: The CHCs in China were managed by the government; whereas in Mali; they were overseen by the local population. The most satisfied people in both countries were those living in the poorest socioeconomic conditions; the elderly; and those who attended the healthcare meetings. Chinese households were more satisfied with the quality of the CHC services than those in Mali. The Chinese management boards proposed standardisation of rules and more funding; whereas those in Mali advocated that government provide more funding and human resources allocation. Conclusion: A high level of satisfaction regarding the CHC services was observed. However; users reported on deficits in the quality of care; whereas management suggested a need for greater resource allocation"